■残疾儿童和青少年面临各种营养问题。这项研究旨在检查饮食特征,营养状况和问题,肠胃健康,以及残疾儿童和青少年的生活质量。
■这项研究包括5-18岁的残疾儿童和青少年(n=1,991)。我们使用地中海饮食质量指数(KIDMED),胃肠道症状评定量表(GSRS),和儿科生活质量量表(PedsQL)来评估饮食特征,肠胃问题,和生活质量。我们收集了24小时的回顾性食物记录,以评估能量和营养素的摄入量。
■残疾儿童的发育迟缓率在16.5%到19.8%之间。在比较残疾类型时,更多身体残疾儿童体重不足(8.8%vs.6.7%)和发育不良(19.8%与16.5%),而更多的智障儿童身高(7.9%vs.5.5%)和超重/肥胖(21.1vs.17.2%;p<0.05)。浪费(9.3%)和超重/肥胖(23.8%)在5-7岁的残疾儿童中更为常见(p<0.001)。食欲不振等饮食问题,拒绝食物,食物恐惧症,食物选择性在5-7岁的儿童中更为常见,在13-18岁的青少年中,快速进食和暴饮暴食的问题更为常见(p<0.05)。在残疾儿童和青少年中,摄入不足的营养素是维生素E,维生素B1,叶酸,钾,钙,铁,而摄入量超过要求的营养素是蛋白质,碳水化合物,维生素A,B2、B6、B12和C,磷,锌,和钠。具有良好地中海饮食质量的参与者的能量和营养摄入量更高,满足营养需求的百分比更高(p<0.05)。KIDMED评分与GSRS总分(r=-0.14,p<0.001)和亚分量评分(腹痛,腹泻,反流,消化不良,和便秘;p<0.05),与PedsQL总量呈显著正相关(r=0.12,p<0.001)。GSRS得分增加一个单位导致PedsQL得分减少14.4倍,KIDMED评分增加1个单位导致PedsQL评分增加10.8倍(p=0.001).
■超重/肥胖,发育迟缓/浪费,营养问题,缺陷在残疾儿童和青少年中很常见。地中海饮食与更好的生活质量有关,和残疾儿童的胃肠道健康。
Children and adolescents with disabilities face various nutritional problems. This study aimed to examine dietary characteristics, nutritional status and problems, gastrointestinal health, and quality of life in children and adolescents with disabilities.
This study included 5-18 years old children and adolescents (n = 1,991) with disabilities. We used the Mediterranean Diet Quality Index (KIDMED), the Gastrointestinal Symptom Rating Scale (GSRS), and the Pediatric Quality of Life Inventory (PedsQL) to assess diet characteristics, gastrointestinal problems, and life quality. We collected retrospective 24-h food record to assess energy and nutrient intakes.
The rate of stunting in children with disabilities varies between 16.5% and 19.8%. When comparing disability types, more children with physical disabilities were underweight (8.8% vs. 6.7%) and stunted (19.8% vs. 16.5%), while more children with intellectual disabilities were tall (7.9% vs. 5.5%) and overweight/obese (21.1 vs. 17.2%; p < 0.05). Wasting (9.3%) and overweight/obesity (23.8%) were more common in children with disabilities aged 5-7 years (p < 0.001). Eating problems such as loss of appetite, food refusal, food neophobia, and food selectivity were more common in children aged 5-7 years, and problems with fast eating and overeating were more common in adolescents aged 13-18 years (p < 0.05). Among children and adolescents with disabilities, the nutrients with inadequate intakes were vitamin E, vitamin B1, folate, potassium, calcium, and iron, while the nutrients with intakes above the requirements were proteins, carbohydrates, vitamins A, B2, B6, B12, and C, phosphorus, zinc, and sodium. Participants with good Mediterranean diet quality had higher energy and nutrient intakes and higher percentages of meeting nutrient requirements (p < 0.05). KIDMED scores were negatively correlated with GSRS total (r = -0.14, p < 0.001) and subcomponent scores (abdominal pain, diarrhea, reflux, indigestion, and constipation; p < 0.05), and significantly and positively correlated with PedsQL total (r = 0.12, p < 0.001). A one-unit increase in the GSRS score resulted in a 14.4 times decrease in the PedsQL score, and a one-unit increase in the KIDMED score resulted in a 10.8 times increase in the PedsQL score (p = 0.001).
Overweight/obesity, stunting/wasting, nutritional problems, and deficiencies are common among disabled children and adolescents. Mediterranean diet is associated with a better quality of life, and gastrointestinal health in children with disabilities.